There are many types of medical procedures involving the removal of bodily fluid from a patient's body. One example of such a medical procedure is hemodialysis treatment. Hemodialysis treatment has been used for many years as a way of treating renal disease and has proven quite useful in providing artificial kidney functions for individuals whose natural kidney functions are impaired. Typically, hemodialysis treatment involves the use of a hemodialysis filter unit, i.e., a dialyzer, that serves as the artificial kidney. Blood that contains waste substances is pumped out of the patient's blood vessel and into the dialyzer which is comprised of a plurality of small plastic tubes or capillaries. These capillaries are bathed with a dialysate solution that is pumped into the dialyzer. As a result, the blood is exposed to diffusive equilibration, thereby resulting in the removal of toxic substances from the blood. The filtered blood then flows out of the dialyzer and is returned to the patient.
Although hemodialysis treatment has been found to be an effective way of treating individuals that lack normal kidney functions, there are problems associated with the procedure. For example, during hemodialysis treatment, the blood is typically pumped out of the patient's body at a rate of between 200-500 ml/min and the pressure within the dialyzer can be as high as 300 mmHg. Given this flow rate of the blood and pressure within the dialyzer, defects in the tubing carrying the patient's blood and defects in the connectors that connect the tubing to the dialyzer are particularly problematic since such defects can result in the patient's blood being sprayed out of the dialyzer. This rupture or leak can take the form of a pressurized or aerosolized stream of blood.
Related problems can also arise at the site of vascular access to the patient's body. In order to gain access to the blood of a patient who requires artificial kidney treatment, a variety of procedures are available for allowing blood to be pumped out of the patient's body and into the dialyzer. The most frequent procedure involves the use of needles which are placed in blood vessels, or a vascular graft which has been placed in the patient's arm. These needles are attached to blood tubing and the blood tubing is connected to the dialyzer. On occasion, a leak or rupture may arise at the site of vascular access, or disconnection of the blood tubing from the needles may occur. This problem is compounded by the fact that the blood is being pumped under pressure at a relatively high flow rate.
The occurrence of ruptures or leaks during the hemodialysis procedure presents particular problems since persons in the area can be exposed to the risk of infectious disease. If the patient undergoing hemodialysis treatment has hepatitis, or is a carrier of a hepatitis virus, or is infected by the HIV virus or some other communicable disease, the individual exposed to the blood rupture or leak may be in serious danger of being infected by such diseases. Such hemodialysis treatment is typically provided in a hemodialysis facility in which several patients being cared for are located in close proximity to one another, the risk associated with a potential rupture is particularly acute.
The possibility that individuals in the vicinity of the hemodialysis procedure, including staff and other individuals, may be exposed to infectious diseases has led to the implementation of protective measures in an attempt to prevent individuals in the area of the hemodialysis treatment from being subjected to infectious diseases. Indeed, the Occupational Safety and Health Administration issued and published final regulations in December 1991 concerning protective devices that must be used by health care workers and others with respect to bloodborne pathogens. The protections to be offered are characterized in the regulations as engineering devices and work practice controls. Engineering devices include such things as personal protection equipment (i.e., gowns, masks, etc.) while work practice controls involve education and other types of measures.
Typically, dialysis facilities require that individuals involved in providing hemodialysis treatment wear gloves, gowns and protective facial devices. However, implementation and enforcement of these protective procedures (i.e., ensuring that all individuals in the vicinity of the hemodialysis treatment adhere to the protective procedures) can be somewhat difficult.